甲亢及甲减患者血浆心钠素变化和与甲状腺素及cGMP关系

重度甲亢组血浆心钠素浓度明显高于正常组,轻中度甲亢组、甲减组与正常组比较无显著差异,甲亢病人经治疗症状控制者较治疗前明显下降,症状未控制者较治疗前无明显改变,甲减病人治疗前后无明显改变。血浆cGMP浓度病人组与正常组比较及治疗前后皆无明显差异。未经治疗的甲亢病人心钠素与T_4、心率呈正相关,与cGMP无相关性。     

甲亢患者血浆心钠素含量的临床观察

本文采用放射免疫分析方法测定了92例甲亢病人和60例正常人的血浆心钠素(ANP)的含量。结果表明,甲亢患者未治组和治疗组血浆ANP含量明显高于正常对照组,经治疗后甲亢缓解组患者血浆ANP含量与正常对照组无差异。而血清T_3、T_4值与血浆ANP含量呈明显的正相关。作者认为测定血浆ANP水平可作为临床上对甲亢病情的估价及血液动力学研究的一项颇有价值的指标。     

甲状腺功能亢进症治疗前后血清r—谷氨酰转肽酶水平的临床观察

本文分析了40例甲亢病者的血清γ-GT的变化,发现甲亢病者在治疗前血清γ-GT水平较治疗后的恢复期及正常人为高。甲亢患者服药治疗后症状缓解,BMR及T_3T_4降到正常范围,其γ-GT与正常人无显著差异。本文说明γ-GT与T_3、T_4、BMR成正相关。初步认为血清γ-GT的测定对无合并症甲亢的诊断及疗效观察具有一定指导意义。本文表明他巴唑不影响血清γ-GT水平。因此,用他巴唑治疗甲亢同131碘一样,血清γ-GT水平可作为治疗观察指标之一。     

甲状腺功能亢进患者心钠素、电解质的观察

本文报告30例甲亢患者血浆心钠素和血清 Na、K、Cl 的测定结果。血浆心钠素显著高于正常对照组,血 Na 显著高于正常对照组,血 K 显著低于正常对照组,血 Cl 与正常对照组无显著差异。其中15例于抗甲状腺药物治疗4—5周后,血浆心钠素和血 Na 显著下降,血 K 显著上升。血清 T_3与血浆心钠素、血浆心钠素与24-h 尿量呈正相关。本文对甲亢患者血浆心钠素、电解质变化的机理、相互关系及其意义进行了讨论。     

“甲亢灵”治疗甲状腺机能亢进症的临床观察

本文收治73例甲亢患者,其中甲亢灵组60例,他巴唑组13例。甲亢灵组服用甲亢灵(中药基本方加少量他巴唑制成药片,他巴唑每天摄入量为他巴唑组的50％,他巴唑组服用他巴唑、心得安等。3个月为1疗程。结果甲亢灵组总有效率96.7%.其中缓解率63.3％;他巴唑组总有效率77％,其中缓解率30.8％。两组间总有效率及缓解率比较,差别均有显著性意义(P<0.05),说明甲亢灵组疗效高于他巴唑。治疗前后两组患者血清T_3、T_4含量下降的差值比较,差别无显著性意义(P>0.05),说明两组降T_3、T_4的效果相近.疗效指数计分甲亢灵组(3.31±2.53)与他巴唑组(5.15±2.6)比较,差别有显著性意义(P<0.01),说明甲亢灵组能较好地改善临床症状.在治疗过程中,甲亢灵组未见毒副反应发生;他巴唑组发现皮疹3例,白细胞减少2例,肝功受损2例。本文还观察到甲亢患者血液流变性有异常改变,经甲亢灵治疗后,降低了血液粘聚性,对病情改善有一定作用。我们体会到,益气养阴是治疗甲亢的重要法则;还要清热泻火以护气阴;化痰散结、活血袪瘀应贯穿治疗始终。甲亢灵疗效高、毒副反应少,除应用较少量的他巴唑外,中药基本方对改善临床症状、体征、降低T_3、T_4、防止或减轻毒副反应等方面,具有重要的作用。     

甲状腺功能亢进症患者血浆Ghrelin水平的改变及其影响因素探讨

目的 了解甲状腺功能亢进症患者血浆生长激素促分泌素受体的内源性配体Ghrelin水平的改变及抗甲状腺药物治疗对血浆Ghrelin水平的影响.方法 采用酶联免疫法测定正常成人和初发甲亢患者治疗前后血浆Ghrelin水平,分析血浆Ghrelin与FT3、FT4、S-TSH、体质量指数、体脂百分比、空腹血糖的关系.结果 甲亢患者血浆Ghrelin水平较对照组明显降低[分别为(468±136)、(751±212)ng/L,P<0.01].经他巴唑治疗1个月后血浆Ghrelin水平、体质量及BMI升高(P<0.01),他巴唑治疗2个月后血浆Ghrelin水平与正常对照组比较无明显差异[分别为(670±214)、(751±212)ng/L,P0.05].相关性分析表明血浆Ghrelin水平与FT4、FT3浓度呈明显负相关(r=-0.43,r=-0.37,P<0.01),而与S-TSH和体脂百分比呈明显正相关(r=0.29,P<0.01;r=0.26,P<0.05).多元线性逐步回归分析提示FT4是影响血浆Ghrelin水平的独立相关因素.结论 甲亢患者血浆Ghrelin水平的显著降低可能与甲亢患者高水平的甲状腺激素抑制了Ghrelin的分泌有关.     

中西医结合治疗甲状腺功能亢进症的临床分析

目的:观察中西医结合治疗甲状腺功能亢进症的疗效。以及对患者实验室相关指标的影响,为临床使用提供理论依据。方法:全部病例系2004年2月~2007年5月本院门诊和住院患者,共120例,按数字表法随机分为治疗组60例和对照组60例。对照组采用他巴唑常规治疗,治疗组用中药当归六黄汤和他巴唑,总疗程2个月。结果:治疗组治愈率及有效率均明显高于对照组(P<0.05),与治疗前相比治疗组与对照组治疗后FT3、FT4均有显著下降(P<0.01),且治疗组FT3、FT4下降幅度优于对照组(P<0.01)。结论:当归六黄汤加他巴唑治疗甲亢患者的疗效确切,既能有效地控制甲亢的症状,并且对于甲亢患者的甲状腺激素也有显著调节作用,减少西药的用量和副作用。     

甲状腺功能亢进患者循环心钠素的观察

用放射免疫分析法测定甲状腺功能亢进患者体内循环心钠素(ANP)含量,结果发现甲亢组血浆ANP含量为487±192pmol/L,非甲亢组和正常组分别是143±52pmol/L和111±76pmol/L.甲亢组ANP含量明显高于正常组(p<0.01),而非甲亢组则与正常组无差异(p>0.05).甲亢患者循环ANP增加可能是T_3、T_4直接刺激心房分泌ANP的结果.     

甲状腺功能亢进患者治疗前后血浆B型钠尿肽的改变及机制

目的:探讨甲亢不伴有明显心功能不全患者治疗前后血浆B型钠尿肽(BNP)的改变及机制。方法:采用酶联免疫法(ELISA)检测66例甲状腺功能亢进患者治疗前及治疗4周后BNP水平,并分析BNP与血浆FT3、FT4的相关性,同时入选48例甲状腺功能正常患者作为对照组。结果:甲状腺功能亢进患者治疗前BNP水平显著高于对照组(P<0.01),经抗甲状腺药物治疗8周后,甲状腺功能亢进患者血浆BNP、FT3、FT4显著下降,BNP下降水平与FT3、FT4下降水平呈正相关。结论:在不伴有心功能不全甲状腺功能亢进患者中,BNP水平较对照组也明显增高,其机制与甲状腺激素对心肌的刺激作用有关,在抗甲亢治疗后,伴随着甲状腺激素的下降,BNP水平也逐渐恢复正常。     

甲亢患者组织缺氧机制的研究及其临床意义

本文对135例经~(131)碘摄取率或 T_3、T_4确诊的甲亢患者(未经治疗100例、经治疗35例)和年龄相近的正常人进行血气分析,结果未治疗组 PVO_2比对照组明显增高(P<0.05),a-VDO_2小于治疗组(P<0.05),PVO_2与心率呈正相关(r=0.287,P<0.01),与 T_4浓度亦呈正相关(r=0.279,P<0.05),PaO_2和 pH 均在正常范围。以上观察提示甲亢患者摄氧率低于正常人,治疗后 PVO_2恢复到正常;PaO_2、PVCO_2、pH 正常,PVO_2、SaO_2、a-VDO_2升高,甲亢病人血气分析可作为诊断甲亢的依据,PVO_2与 T_4浓度,心率呈正相关,因此可作为鉴定甲亢的严重程度和对治疗反应的方法之一。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.